Guest Commentary: Amazing opportunity for Medicaid expansion

May 7, 2014

We have a serious problem in the state of Florida and Lee County. The state has the country's second-highest uninsured rate in the country. Nearly one-quarter Floridians under 65 lack health care and it is estimated 127,000 live in Lee County.

Medicaid Expansion to the Affordable Care Act is the solution and it is in the hands of the members of the Florida Legislation who can opt in or opt out at any point. They can vote to accept the $5.1 billion per year for 10 years for Medicaid expansion under the Affordable Care Act. For the first three years, the federal government pays for everything. Over the next 10 years, the government pays a gradually decreasing amount but continues to cover 90 percent of costs.

It is incomprehensible that the Republican-dominated legislature has no plans to bring it up this year and couldn't reach an agreement on these set-aside federal funds last year. The legislature should put this on the agenda, look for creative solutions, and bring it up for vote again while they are in session. We have already lost one year of 100 percent funding of $5.1 billion. Other conservative states are implementing the expansion. Conservative stalwarts, including Arizona Gov. Jan Brewer and Ohio Gov. John Kasich, have argued an expansion is the right thing to do, morally and economically, and have already signed Medicaid expansion into law.

A creative solution has been proposed by Sen. Bill Nelson and supported by Jim Nathan, President and CEO of the Lee Memorial Health System. Under this plan, hospital taxing districts and public health systems would pick up the state's portion of the expansion. According to Sen. Nelson, he received a letter from a representative of the Centers of Medicare and Medicaid Services, indicating a willingness to work with Florida on an alternate solution. The hospitals already raise money for indigent care and they would never have to pay more than 10 percent of the expansion. His plan would require the 32 counties that boost their hospitals' Medicaid funding with local dollars to instead use $3.5 billion of that money to cover the state's part of the expansion for 10 years. All 67 Florida counties would benefit, even if they didn't contribute.

One argument against Medicaid expansion for states is that it would put a tremendous strain on state budgets. This alternate solution would take away any burden of funding from the state of Florida. This expansion makes good business sense for Florida because it would fuel job creation, which automatically leads to more tax revenue for state. The Florida Hospital Association reports that the economic impact of this expansion will create 121,000 jobs, including more than 10,000 in our community. Leading businesses like Disney, Lockheed-Martin, Florida Power & Light and Publix Super Markets, Blue Cross/Blue Shield, and Lee Memorial Health Systems all recommend accepting Medicaid expansion dollars. Florida citizens with insurance are already paying for the hidden costs of uninsured at emergency rooms.

Another argument against Medicaid expansion is that the Federal government cannot afford it and cannot be trusted to deliver. In truth, the federal government has reliably paid out trillions of dollars in big programs such as Medicaid, Medicare and Social Security over many years. In addition, the Federal government has been decreasing our deficits in last few years. Deficits, as a percentage of gross domestic product, fell from 10.1 percent in 2009 to 7 percent in 2012. In regard to these federal funds slated for Medicaid expansion, State Sen. Nan Rich, D-Weston said, "Ultimately, all the states will realize how destructive it is not to be a part of it and draw down the money that their taxpayers have paid to the federal government."

Last year the legislators said they would listen if they weren't saddled with any cost. Now is the time for them to listen before we lose two years of full federal funding for Medicaid expansion. Please contact your legislators on behalf of these hard-working Floridians for humanitarian and business reasons to revisit expanding Medicaid this year.

Sandra McClinton, of Cape Coral, is the Region VII Chair of the Democratic Women's Club of Florida and former Chair of the Democratic Party of Lee County